• Medical Affairs

  Medical Waiver Program

  Public Health Service Officers can have health conditions that make it unsafe for them to participate in or to complete some readiness requirements. The purpose of the Medical Waiver Program is to assist the U.S. Public Health Service Commissioned Corps in implementing policies on medical and force readiness, while, at the same time, reducing the Officer’s risk of unintended injury or worsening of an existing medical condition. This program is administered by the Medical Affairs Branch (MAB) within Commissioned Corps Headquarters. Approval of Medical Waiver requests is not guaranteed. MAB has sole discretion of approval and time limitations of all medical waivers.

  An officer may require a temporary medical waiver due to a medical condition that, affects his/her health status or personal well-being. Such conditions may pose specific or general physical limitations or restrictions on the officer’s ability to reach optimal medical readiness. Therefore, officers may be medically exempt from meeting one or more of the standards for medical readiness and basic level of force readiness. These exemptions are only allowed when a valid medical reason exists which is supported by appropriate medical documentation.

  Long term renewable medical waivers may be granted for select permanent medical conditions. However, long term renewable waivers are not intended to permanently exempt officers from ever being deployed or having to complete the cardiorespiratory endurance section of the Annual Physical Fitness Testing (APFT).

  Medical waivers are personal exemptions from performing or engaging in one or more of the following activities:

  • Deployment;
  • Receiving one or more immunization;
  • Performance of all or part of the APFT;
  • Meeting weight standards;
  • Maintaining uniform requirements (e.g., beard waivers, shoe waivers);
  • Completing Basic Life Support training; or
  • Fulfilling other requirements necessary for meeting and/or maintaining the Basic level of force readiness.

  Types of Waivers

  • Temporary time-limited medical waivers may be granted for a documented health condition that is likely to improve within 12 months, or less, from the date that the request was received by MAB.
  • Permanent long-term renewable medical waivers may be granted for conditions that are unlikely to improve in the foreseeable future. Examples of this type of waiver are for certain immunizations which are contraindicated in individuals with severe egg allergies or uniform (beard) waivers for individuals with certain chronic dermatologic conditions

  Medical Readiness Categories (MRC)

  MAB uses MRCs to communicate internally to Readiness and Deployment Branch (RDB) about an officer’s medical deployment status without disclosing protected health information. There are four categories:

  • MRC-1: Fully deployable,
  • MRC-2: Deployable with limitations or specific needs,
  • MRC-3: Non-deployable, and
  • MRC-4: Critical information pending-Currently non-deployable.

  Officers are assigned an MRC after review of medical documentation by MAB. The assigned category is transmitted digitally to RDB without disclosing any protected health information.

  MRC-2 assignment is usually tied to documentation submitted with a medical waiver requests. For example, an Officer needs a reliable source of electricity to operate a medical devise and requests a deployment waiver. MAB may assign the Officer an MRC-2, “requires reliable electricity.” RDB is now obliged to ensure that the Officer’s need is met wherever the Officer is deployed. Another Officer has medical conditions that will put the Officer at risk for serious infections and asks for a deployment waiver. If appropriate, rather than grant the waiver, MAB will assign the Officer to MRC-2, “No exposure to severe infections.” RDB will then only deploy that Officer if their deployment role does not require the Officer to have potential contact with serious infections. Since being able to deploy is a condition of service, assigning an Officer an MRC-2 allows the Officer to be deployable while ensuring that the Officer’s limitations or needs are considered.

  Unfortunately, Officers cannot yet see their assigned MRC on their Readiness dashboard. We hope that will be possible in the future.

  Clarification of Specific Medical Waivers

  Pregnancy: As of January 15, 2021, there are significant changes in what is included in a Pregnancy waiver which are summarized below:

  Length of Pregnancy	Waiver	Waiver requested January 15, 2021 or prior	Waiver requested after January 16, 2021
  ≥ 20 weeks	Deployment, APFT, BLS, Live virus immunizations	Expires 6 months after estimated date of delivery	Expires 12 months after estimated date of delivery. NO BLS WAIVER INCLUDED
  	Weight Standards	Expires 6 months after estimated date of delivery with an option for an additional 3 months	Expires 12 months after estimated date of delivery
  	Breastfeeding	Additional 6 months after expiration of Pregnancy waiver (12 months after child’s birthday)	Included in pregnancy waiver, expires 12 months after estimated date of delivery
  < 20 weeks	Deployment, APFT, BLS, Live virus immunizations, Weight standards	Not in policy	Expires 6 months after termination of pregnancy. NO BLS WAIVER INCLUDED

  If an officer’s pregnancy ends prior to 20 weeks gestation, the officer should inform Medical Affairs within 30 days by uploading a Waiver request form with the date the pregnancy ended. Please note:

  The Pregnancy waiver NO LONGER INCLUDES A WAIVER FOR BASIC LIFE SUPPORT certification. If an officer knows that her BLS certification will expire during the period covered by the Pregnancy waiver, she should arrange to renew her certification early in her pregnancy or after delivery.

  The readiness requirements of the annual Periodic Health Update (PHU) and annual seasonal Influenza immunization are NOT waived by the Pregnancy waiver.

  Pertussis vaccine in the form of Tdap is now recommended during the third trimester of every pregnancy. If an officer’s tetanus immunization expires early in her pregnancy, to avoid being found not basic qualified, the officer should request a tetanus waiver until her third trimester.

  Breastfeeding: Breastfeeding waivers are now included in the Pregnancy waiver. Requests for a breastfeeding waiver after the child’s first birthday will only be considered if there is documentation from a healthcare provider that terminating breastfeeding (not just dietary supplementation which can be done with expressed breastmilk) will significantly adversely affect the health of the officer or her child.

  Retention Weight Standards: Some medical conditions or treatments can contribute to changes in weight or difficulty gaining or losing weight. When an officer requests a weight standards waiver, his/her healthcare provider must submit to MAB evidence-based data from the scientific literature regarding the effects of the condition or treatment on weight. The officer must also provide a pretreatment weight. If a waiver is granted, the extent of relaxing the standards will be based on the documented effects of the treatment. MAB will utilize peer reviewed medical literature to determine the effects of a treatment.

  Submission of a Medical Waiver Request

  Medical waiver requests should be submitted on the Active Duty and Reserve Corps Medical Waiver Request form (312kb, pdf) with the required medical documentation from your provider(s):

  • What are your specific disabling medical diagnoses, condition(s) or disabling symptoms?
  • What is your present management of these conditions or symptoms, to include diagnostic and/or treatment plan(s)?
  • How does the condition(s) prohibit you from completing readiness requirements including deployments?
  • What is the prognoses for your condition(s)/symptoms (if known), permanent or temporary?
  • When should the waiver expire or when is the next reevaluation date?

  The request form and the medical documentation must be attached as a single PDF file. Upload the single PDF file in the Medical section of eDOC-U using the document name, “Request for Medical Waiver.” Officers will not be sent a confirmation of the granting of a waiver. You can review his/her waiver status by going to their Readiness Self-Service Page, selecting the Readiness Information page, and then clicking the Waiver tab. MAB will communicate with officers if the waiver request is denied or there are questions about the request.

  For more information, please contact Medical Affairs at: PHSMACCHQ@hhs.gov
• USER ASSISTANCE

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  The Commissioned Corps Bulletin for April 2021

  The Commissioned Corps Bulletin for April 2021

  January 2021: United States Public Health Commissioned Corps Doctrine

  The link above will take you to the Noncompetitive Promotion Roster for Promotion Year 2020.

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  As we position ourselves to assist with controlling the spread of the Coronavirus Disease 2019 (COVID-19), please note that we’re in an “all-hands on deck” status. Messaging has gone out from the Assistant Secretary for Health reminding Commissioned Corps officers of their deployment responsibilities...

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